Pain in the shin

Shin pain often occurs as a result of heavy exertion during sports activities. The symptoms usually go away on their own if the leg is spared for a while. However, shin pain should not be taken lightly, as the symptoms can also be caused by a serious illness. For example, pain in the shin occurs with inflammation of the tendons, muscles or the shin bone. It is not uncommon for fractures in the area of ​​the shin to occur as a result of accidents, some of which have to be treated surgically.

Symptoms

Often, shin pain occurs as a result of overload. Many runner are all too familiar with the symptoms. This usually shows pulling pain below the kneecap or pulling pain that extends along the shinbone.

Shin splints

The so-called shin splint syndrome is pain that usually occurs as a result of sporting activities such as running or soccer, which put a lot of strain on the shin and foot muscles. In specialist circles, the syndrome is often not seen as an independent clinical picture, but rather as a symptom with many possible causes. Overuse of the muscles is discussed as a trigger.

This mainly affects untrained people who start exercising. But even trained athletes can suffer from shin splints if, for example, shoes are changed or those affected gain weight. The muscles around the tibia can be irritated and inflamed. Affected people sometimes have to be prepared for a longer treatment of the tibial splint syndrome.

Periosteum inflammation

The periosteum of the tibia can also be affected by inflammation. A so-called periosteum inflammation can sometimes be very protracted and painful. These are possible triggers of the inflammation:

• Overload,
• wrong footwear,
• changed training conditions,
• Change of training type,
• overtired muscles,
• wrong training,
• external stimuli such as blows or kicks,
• Pathogens such as bacteria or viruses.

Osteomyelitis

In osteomyelitis , the bone marrow is inflamed. Often, however, all parts of the bone are affected by the inflammation. Then there is talk of an osteitis ( inflammation of the bones ). Both bone marrow and bone inflammation usually occur as a result of open fractures or operations in which the contamination with pathogens occurs. Affected people sometimes suffer from severe shin pain.

Tendinitis

Another cause of discomfort in the shin bone can be tendinitis (tendovaginitis) at the point of attachment of the shin muscles. Those affected should take care of the leg until it has healed in order to avoid chronic tendinitis.

Fractures

Accidents can also lead to fractures of the shin, which are associated with movement and spontaneous pain, significant swelling and loss of function of the leg. A misalignment of the lower leg is often noticeable. In principle, a fracture can occur at any point on the tibia. The tibia head or the rear edge of the tibia at the upper ankle joint (Volkmann injury) are often affected. In addition, the shank can break, for example as a result of traffic accidents.

This injury is also not uncommon for athletes. Often it is a fatigue fracture that occurs due to permanent overloading of the bone. Another underlying disease can also be the cause of a fracture of the tibia. In osteoporosis or rheumatoid arthritis , the bone can be attacked so severely that it becomes porous and eventually breaks.

 

Bottleneck Syndrome

Shin pain can also result from pinching or pinching muscles, blood vessels and nerves (bottleneck syndromes). There is little space between the individual muscles in the lower leg. This is why leg swellings are quickly noticeable and quickly lead to discomfort.

Compartment syndrome

A special cause of the complaints is the so-called compartment syndrome, which can arise as a result of bone fractures. Increased tissue pressure in the so-called muscle boxes leads to reduced blood flow and, if there is no therapy, permanent damage to the blood vessels, muscles and nerves. Thick calves can be the first clue of the syndrome.

The functional compartment syndrome, from which athletes are affected, has a special position. While the tissue has to be surgically relieved in the acute compartment syndrome in order to prevent consequential damage, the symptoms in the functional compartment syndrome subside when the patient is at rest.

Other causes

There are other possible cause of shin pain as well. These include, for example:

• Skin diseases such as neurodermatitis ,
• Tumors,
• neurological diseases,
• Circulatory disorders ,
• prolonged use of cortisone,
• Overactive parathyroid glands (hyperparathyroidism),
• Deficiency symptoms, for example with diets that are too strict,
• Menopause or menstrual cycle in women.

Risk Factors and Prevention

Often times, pain in the shin is the result of excessive strain or untrained muscles. Regular strengthening exercises for the lower leg muscles , frequent barefoot walking and standing on the toes all contribute to strengthening the shin muscles. Runners should pay attention to suitable footwear and the right running technique, because overloading often leads to the complaints that can arise, for example, from walking forefoot. In addition, moderate training on soft forest floors prevents pain in the shin. Other preventive measures are:

• Exercise in moderation and not go beyond the limit.
• Take regular rest days.
• Get on slowly after a break from training.
• Have a treadmill analysis performed when buying running shoes.
• Compensate for misalignment of the feet with suitable insoles.

diagnosis

The pain can have many causes. That is why it is important to make an accurate diagnosis. For this purpose, the patient's medical history (anamnesis) is used first. Questions are asked about previous illnesses such as rheumatism and previous accidents. The shin is carefully examined and the lower leg is checked for restricted mobility, excessive mobility and bone malpositions. In this way, for example, a broken tibia is often immediately recognizable. During examinations, complaints such as numbness in the legs , lower back pain or buttock pain should be reported to the doctor or therapist. Further diagnostic options are:

• X-ray examinations,
• Blood tests to determine inflammation levels
• Sonographies (ultrasound examinations),
• Magnetic resonance imaging (MRI),
• neurological and electrophysiological examinations.

Anatomy of the tibia

Shin pain is painful discomfort in the area of ​​the lower leg, the shin. The fibula and tibia together form the bony part of the lower leg. The shin bone shaft is triangular in shape. Towards the knee, it widens to the head of the tibia and is also part of the knee joint. The tibia widens towards the ankle and forms a substantial part of the surface of the upper ankle and the medial malleolus. Certain knee pain and ankle pain are therefore sometimes counted as complaints on the shin.

treatment

Shin pain usually disappears on its own if the leg is spared for a while and strenuous sports are exposed. If this is not the case, therapy is required, which usually depends on the cause.

Therapy for inflammatory causes

If there is inflammation such as tendonitis, anti-inflammatory pain relievers are given. Ointments are also often used. Temporary protection of the lower leg is usually unavoidable. In the case of severe or chronic disease, this can result in temporary immobilization with a special bandage, plaster splint or plaster cast. Cold or heat therapy and physiotherapy can also be useful, depending on the cause. In rare cases, a chronic tendinitis is operated on.

Treatment of fractures or acute compartment syndrome

In the case of fractures of the tibia, surgical intervention may be necessary in which the fracture is straightened using screws, nails and plates. This is usually followed by immobilization of the lower leg. Even with acute compartment syndrome, conservative measures are not enough. The pressed muscles, nerves and blood vessels then have to be surgically relieved.

Naturopathic treatment for shin pain

Shin pain that is not related to a disease or injury is often attributed to a functional cause. In such cases, the complaints can often be treated successfully through natural healing and alternative medical methods. It is important to see the lower leg in relation to the entire leg and foot. Both the gait and running pattern as well as the footwear are included in the analysis. This is for example the case with the concept of body work according to the biochemist Dr. Ida Rolf ( Rolfing ) or osteopathy is the case. Unusual stresses and tensions are identified and dealt with. The course of the nerves is also examined for possible pinches down to the pelvis.

Exercises to strengthen the muscles in the shin area

These exercises can be incorporated into training units to strengthen the muscles in the area of ​​the shin, because untrained people in particular quickly experience pain in this area when they are exerted. A trained muscle can help prevent shin pain. However, it is important to avoid excessive exercise as this can also be a trigger for shin pain. If the muscle hurts or shows signs of fatigue, the training should be stopped and a corresponding rest phase should follow.

Lunge steps

1. Stand upright and tense your abdominal muscles.
2. The feet are hip width apart.
3. Take a big step forward and breathe in.
4. Keep the step position briefly, the knee should not point over the tip of the foot.
5. Press again with the front leg and return to the starting position, exhaling as you do so.
6. Repeat the exercise with the other leg.

 

Squats

 

1. Stand upright and tense your abdominal muscles.
2. Place your feet slightly above the width of your hips.
3. Toe tips point outwards very slightly.
4. Bend your legs as if to sit on the edge of a chair.
5. Do not fall below a knee angle of 90 degrees.
6. Keep your back straight and your knees shouldn't reach over your toes.
7. Hold briefly, then return to the starting position.

 

Tip toe

1. Stand hip-width apart with knees not very slightly bent,
2. Tense stomach and bottom,
3. lift both heels off the ground,
4. hold on tiptoe for a few seconds,
5. Slowly lowers your heels back to the ground,
6. Repeat the exercise as often as you like.